Ziguang Zhou1. 1. Department of Orthopaedics, Pinggu Hospital of Beijing, Beijing 101200, PR China. zgzhou5@sina.com
Abstract
OBJECTIVE: To explore the treatment of low-energy tibial plateau fractures with arthroscopic percutaneous osteosynthesis. METHODS: From May 2004 to April 2008, 27 cases of tibial plateau fractures were treated with arthroscopic management. There were 19 males and 8 females, aged 18-61 years old (mean 41.5 years old). Fracture was caused by traffic accident in 18 cases, by falling from height in 6 cases, by bruise in 2 cases, and by other in 1 case. There were 8 cases of type I, 12 cases of type II, 2 cases of type III and 5 cases of type IV according to Schatzker classification. The time from injury to operation was 3-15 days (mean 5.2 days). After symptomatic managements were performed arthroscopically in 11 cases of meniscus tear, 4 cases of medial collateral ligament rupture of knee joint, 3 cases of anterior cruciate ligament rupture of knee joint and 2 cases of cartilage fracture resulting in joint bodies, fracture was reduced and fixed with 2 or 4 cannulated screws (7 mm in diameter). Autograft of ilium was given 6 cases of bone defect. Early functional exercise was done. RESULTS: The operation time was 55-150 minutes (mean 93 minutes); the hospitalization days were 7-22 days (mean 16 days). All incision healed primarily. Edema of the affected leg occurred in all patients and subsided after 3 days of symptomatic management. In one patient who did not cooperate in functional exercise, adhesion occurred and normal function was recovered after by manual dissolution under conditions of anesthesia after 3 months of operation. All patients were followed up 6-36 months (mean 16.6 months). The range of motion of knee joint was 105-140 degrees (mean 121 degrees). According to Lysholm scale of knee joint, the score was 72-100 points (mean 93.6 points) 6 months after operation. The X-ray film showed no signs of osteoarthritis. CONCLUSION: Arthroscopic percutaneous osteosynthesis yields satisfactory results and can be accepted as an alternative and effective method for the treatment of low-energy tibial plateau fractures.
OBJECTIVE: To explore the treatment of low-energy tibial plateau fractures with arthroscopic percutaneous osteosynthesis. METHODS: From May 2004 to April 2008, 27 cases of tibial plateau fractures were treated with arthroscopic management. There were 19 males and 8 females, aged 18-61 years old (mean 41.5 years old). Fracture was caused by traffic accident in 18 cases, by falling from height in 6 cases, by bruise in 2 cases, and by other in 1 case. There were 8 cases of type I, 12 cases of type II, 2 cases of type III and 5 cases of type IV according to Schatzker classification. The time from injury to operation was 3-15 days (mean 5.2 days). After symptomatic managements were performed arthroscopically in 11 cases of meniscus tear, 4 cases of medial collateral ligament rupture of knee joint, 3 cases of anterior cruciate ligament rupture of knee joint and 2 cases of cartilage fracture resulting in joint bodies, fracture was reduced and fixed with 2 or 4 cannulated screws (7 mm in diameter). Autograft of ilium was given 6 cases of bone defect. Early functional exercise was done. RESULTS: The operation time was 55-150 minutes (mean 93 minutes); the hospitalization days were 7-22 days (mean 16 days). All incision healed primarily. Edema of the affected leg occurred in all patients and subsided after 3 days of symptomatic management. In one patient who did not cooperate in functional exercise, adhesion occurred and normal function was recovered after by manual dissolution under conditions of anesthesia after 3 months of operation. All patients were followed up 6-36 months (mean 16.6 months). The range of motion of knee joint was 105-140 degrees (mean 121 degrees). According to Lysholm scale of knee joint, the score was 72-100 points (mean 93.6 points) 6 months after operation. The X-ray film showed no signs of osteoarthritis. CONCLUSION: Arthroscopic percutaneous osteosynthesis yields satisfactory results and can be accepted as an alternative and effective method for the treatment of low-energy tibial plateau fractures.